The Southeastern Kidney Transplant (SEKTx) Coalition is an academic-community collaboration between partners in the kidney disease community who share the common goal of eliminating health disparities in access to kidney transplantation among African American End Stage Renal Disease (ESRD) living in Georgia, North Carolina, and South Carolina. Volunteer members of this community-based coalition include ESRD and transplant patients, dialysis facility staff and providers, transplant centers, quality improvement organizations, and patient advocacy organizations. The burden of CKD and ESRD is highest in the Southeast, and yet the rate of kidney transplantation is the lowest in the nation. Further, our research suggests that racial disparities in access to transplant are concentrated in the Southeast, where African Americans (AA) are less likely to access each step in the transplant process. In 2014, our SEKTx Coalition conducted a randomized, multicomponent intervention (Reducing Disparities In Access to kidNey Transplantation [RaDIANT]) Community Study in GA, the state with the lowest kidney transplant rates in the nation, consisting of patient- and provider-focused educational and engagement interventions designed to increase referral for transplant evaluation among AA ESRD patients. This study was effective in improving referral for kidney transplantation among AA in GA, but efforts to improve access to kidney transplantation must be expanded beyond GA and should include interventions targeting steps beyond referral to the medical evaluation at the transplant center. The long-term goal of the SEKTx Coalition is to eliminate racial disparities in every step of the kidney transplant process. Our Specific Aims are: Specific Aim 1. Determine reasons for racial disparities in medical evaluation for kidney transplantation among dialysis patients in GA, NC and SC. Specific Aim 2: Implement the RaDIANT Regional Study in GA, NC, and SC with the goal of increasing rates of referral, medical evaluation, and waitlisting, and reducing disparities in these key steps. Specific Aim 3: Conduct a process and outcome evaluation of the RaDIANT Regional Study interventions. The overall impact of this proposal is to improve transplant access among the AA ESRD population in the Southeast and reduce health disparities in transplantation.